Legal Study of Medical Letters of Clearance

Nowadays, it is popular in medical practice that when a patient refers to a physician to be cured (in particular if it requires surgical operations), the patient or her/his relatives have to sign a formal letter of clearance and then the physician will begin to treat the patient; for, except in emergency cases, such letter of clearance is the proficient physician's only means to be cleared of responsibilities; and, evidently, the physician will not ignore it. Nevertheless, medical centers and hospitals do not suffice to take only such letters of clearance; but rather, they take a letter of consent as well which clears the physician of penal responsibility while the letter of clearance clears her/him of civil responsibility. Thus, it should be found that what the value of condition of clearance or letter of clearance is. May one believe in its authenticity and correctness, and may it be effective? Does taking a letter of clearance mean that a proficient physician is cleared of civil and/or penal responsibility? Does it mean that she/he is not responsible at all? Finally is it sufficient to merely take a letter of clearance from the patient or her/his relatives and no letter ofconsent is needed?